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논문 기본 정보

자료유형
학술저널
저자정보
저널정보
대한암학회 Cancer Research and Treatment Cancer Research and Treatment 제48권 제1호
발행연도
2016.1
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106 - 114 (9page)

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Purpose This study was conducted to evaluate clinical outcomes following definitive concurrent chemoradiotherapy (CCRT) for patients with N3-positive stage IIIB (N3-IIIB) non-small cell lung cancer (NSCLC), with a focus on radiation therapy (RT) techniques. Materials and Methods From May 2010 to November 2012, 77 patients with N3-IIIB NSCLC received definitive CCRT (median, 66 Gy). RT techniques were selected individually based on estimated lung toxicity, with 3-dimensional conformal RT (3D-CRT) and intensity-modulated RT (IMRT) delivered to 48 (62.3%) and 29 (37.7%) patients, respectively. Weekly docetaxel/paclitaxel plus cisplatin (67, 87.0%) was the most common concurrent chemotherapy regimen. Results The median age and clinical target volume (CTV) were 60 years and 288.0 cm3, respectively. Patients receiving IMRT had greater disease extent in terms of supraclavicular lymph node (SCN) involvement and CTV ! 300 cm3. The median follow-up time was 21.7 months. Forty- five patients (58.4%) experienced disease progression, most frequently distant metastasis (39, 50.6%). In-field locoregional control, progression-free survival (PFS), and overall survival (OS) rates at 2 years were 87.9%, 38.7%, and 75.2%, respectively. Although locoregional control was similar between RT techniques, patients receiving IMRT had worse PFS and OS, and SCN metastases from the lower lobe primary tumor and CTV ! 300 cm3 were associated with worse OS. The incidence and severity of toxicities did not differ significantly between RT techniques. Conclusion IMRT could lead to similar locoregional control and toxicity, while encompassing a greater disease extent than 3D-CRT. The decision to apply IMRT should be made carefully after considering oncologic outcomes associated with greater disease extent and cost.
#Non-small cell lung carcinoma #Concurrent chemoradiotherapy #Stage IIIB-N3 #Intensity-modulated radiotherapy

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참고문헌 (25)

참고문헌 신청
National Comprehensive Cancer Network / NCCN guidelines version 3, 2014. Non-small cell lung cancer google schola Auperin A / 2010 / Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non-small-cell lung cancer / J Clin Oncol 28:2181~2190 google schola Curran WJ Jr / 2011 / Sequential vs. concurrent chemoradiation for stage III non-small cell lung cancer: randomized phase III trial RTOG 9410 / J Natl Cancer Inst 103:1452~1460 google schola Ramnath N / 2013 / Treatment of stage III non-small cell lung cancer : diagnosis and management of lung cancer, 3rd ed : American College of Chest Physicians evidence-based clinical practice guidelines / Chest 143(5 Suppl):314~340 google schola Machtay M / 2012 / Higher biologically effective dose of radiotherapy is associated with improved outcomes for locally advanced non-small cell lung carcinoma treated with chemoradiation : an analysis of the Radiation Therapy Oncology Group / Int J Radiat Oncol Biol Phys 82:425~434 google schola

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